CMS Formulary

Displaying 10021-10030 of 1611142 results.
ID: 10021
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10022
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10023
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 10024
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 10025
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10026
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10027
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10028
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10029
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 10030
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0