CMS Formulary

Displaying 21161-21170 of 1611142 results.
ID: 21161
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21162
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 21163
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21164
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21165
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21166
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21167
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21168
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21169
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21170
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0