CMS Formulary

Displaying 21001-21010 of 1611142 results.
ID: 21001
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21002
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21003
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21004
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21005
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21006
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21007
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21008
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 21009
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 21010
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0