CMS Formulary

Displaying 21301-21310 of 1611142 results.
ID: 21301
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21302
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 21303
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 21304
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 21305
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21306
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 21307
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 21308
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 21309
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 21310
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0