CMS Formulary

Displaying 20341-20350 of 1611142 results.
ID: 20341
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 20342
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 20343
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20344
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20345
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 20346
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 20347
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 20348
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 20349
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 20350
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30