CMS Formulary

Displaying 21221-21230 of 1611142 results.
ID: 21221
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 21222
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 21223
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21224
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21225
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21226
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21227
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21228
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21229
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21230
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0