CMS Formulary

Displaying 22151-22160 of 1611142 results.
ID: 22151
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22152
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22153
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 22154
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 22155
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 22156
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 22157
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 22158
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 22159
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22160
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28