CMS Formulary

Displaying 22341-22350 of 1611142 results.
ID: 22341
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257015
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22342
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22343
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044726
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22344
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22345
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22346
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22347
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22348
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22349
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22350
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0