CMS Formulary

Displaying 10321-10330 of 1611142 results.
ID: 10321
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 10322
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 10323
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 10324
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 10325
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 10326
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10327
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10328
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10329
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 10330
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28