CMS Formulary

Displaying 22241-22250 of 1611142 results.
ID: 22241
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22242
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22243
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 860707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22244
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22245
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22246
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22247
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22248
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22249
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22250
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0