CMS Formulary

Displaying 22561-22570 of 1611142 results.
ID: 22561
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22562
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22563
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22564
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22565
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22566
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22567
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22568
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 403875
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22569
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 22570
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0