CMS Formulary

Displaying 22391-22400 of 1611142 results.
ID: 22391
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22392
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22393
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22394
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 180
ID: 22395
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 180
ID: 22396
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22397
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22398
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22399
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22400
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0