CMS Formulary

Displaying 22331-22340 of 1611142 results.
ID: 22331
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22332
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 22333
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 22334
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22335
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22336
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22337
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 22338
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 22339
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 22340
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0