CMS Formulary

Displaying 21331-21340 of 1611142 results.
ID: 21331
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 21332
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 21333
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 21334
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 21335
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 21336
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 21337
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21338
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 21339
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21340
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30