CMS Formulary

Displaying 22871-22880 of 1611142 results.
ID: 22871
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22872
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22873
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22874
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22875
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 22876
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22877
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22878
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22879
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22880
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0