CMS Formulary

Displaying 21151-21160 of 1611142 results.
ID: 21151
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21152
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 21153
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 21154
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21155
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21156
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 21157
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21158
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21159
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 21160
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0