CMS Formulary

Displaying 22681-22690 of 1611142 results.
ID: 22681
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22682
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22683
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 22684
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 22685
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 208083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22686
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054275
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 22687
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22688
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22689
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22690
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30