CMS Formulary

Displaying 21311-21320 of 1611142 results.
ID: 21311
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21312
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21313
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390946
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21314
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21315
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21316
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 21317
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 21318
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 21319
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21320
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0