CMS Formulary

Displaying 22571-22580 of 1611142 results.
ID: 22571
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22572
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 314285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22573
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22574
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 22575
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 180
ID: 22576
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 22577
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 22578
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 22579
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22580
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0