CMS Formulary

Displaying 22811-22820 of 1611142 results.
ID: 22811
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 352297
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22812
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22813
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22814
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22815
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22816
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22817
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22818
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22819
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22820
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30