CMS Formulary

Displaying 20721-20730 of 1611142 results.
ID: 20721
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20722
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20723
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20724
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20725
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20726
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20727
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20728
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20729
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20730
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30