CMS Formulary

Displaying 21181-21190 of 1611142 results.
ID: 21181
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21182
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21183
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 21184
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21185
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21186
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21187
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21188
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21189
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21190
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30