CMS Formulary

Displaying 22201-22210 of 1611142 results.
ID: 22201
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22202
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 22203
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22204
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22205
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22206
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22207
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22208
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22209
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22210
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0