CMS Formulary

Displaying 22271-22280 of 1611142 results.
ID: 22271
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22272
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22273
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 22274
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22275
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22276
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 727714
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22277
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22278
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22279
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22280
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30