CMS Formulary

Displaying 22471-22480 of 1611142 results.
ID: 22471
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 22472
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 22473
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22474
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22475
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22476
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22477
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22478
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22479
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22480
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0