CMS Formulary

Displaying 22901-22910 of 1611142 results.
ID: 22901
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22902
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22903
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22904
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22905
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22906
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22907
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22908
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22909
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22910
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0