CMS Formulary

Displaying 21371-21380 of 1611142 results.
ID: 21371
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21372
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21373
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21374
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21375
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 21376
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 21377
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21378
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21379
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21380
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0