CMS Formulary

Displaying 22261-22270 of 1611142 results.
ID: 22261
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22262
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 22263
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22264
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 22265
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22266
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22267
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22268
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22269
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729029
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22270
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30