CMS Formulary

Displaying 21131-21140 of 1611142 results.
ID: 21131
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21132
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21133
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 21134
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21135
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21136
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21137
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21138
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21139
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21140
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30