CMS Formulary

Displaying 21381-21390 of 1611142 results.
ID: 21381
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21382
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21383
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21384
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21385
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21386
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21387
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21388
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 21389
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 21390
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359340
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21