CMS Formulary

Displaying 21341-21350 of 1611142 results.
ID: 21341
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 21342
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 21343
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 21344
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 21345
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 21346
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 21347
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 21348
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 21349
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 21350
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28