CMS Formulary

Displaying 21171-21180 of 1611142 results.
ID: 21171
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21172
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21173
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21174
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21175
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21176
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21177
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21178
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21179
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 21180
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28