CMS Formulary

Displaying 21351-21360 of 1611142 results.
ID: 21351
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 21352
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21353
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21354
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21355
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21356
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21357
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 21358
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 21359
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 21360
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 84