CMS Formulary

Displaying 22711-22720 of 1611142 results.
ID: 22711
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22712
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22713
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22714
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282414
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22715
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283236
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22716
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 22717
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 22718
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 22719
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 22720
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 28