CMS Formulary

Displaying 22581-22590 of 1611142 results.
ID: 22581
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 22582
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22583
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22584
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22585
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22586
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22587
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22588
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22589
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22590
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790684
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0