CMS Formulary

Displaying 22781-22790 of 1611142 results.
ID: 22781
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 22782
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 22783
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 207834
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22784
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 22785
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22786
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 729234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22787
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 582971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22788
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 582976
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22789
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 22790
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28