CMS Formulary

Displaying 10421-10430 of 1611142 results.
ID: 10421
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10422
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10423
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10424
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10425
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10426
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10427
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 794639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10428
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10429
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10430
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0