CMS Formulary

Displaying 22761-22770 of 1611142 results.
ID: 22761
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22762
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22763
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22764
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22765
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 22766
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 22767
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 22768
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22769
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 22770
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30