CMS Formulary

Displaying 22451-22460 of 1611142 results.
ID: 22451
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22452
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 22453
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22454
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22455
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22456
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22457
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22458
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22459
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988308
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22460
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0