CMS Formulary

Displaying 22291-22300 of 1611142 results.
ID: 22291
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22292
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22293
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22294
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22295
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22296
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 22297
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22298
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22299
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22300
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0