CMS Formulary

Displaying 21391-21400 of 1611142 results.
ID: 21391
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 21392
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21393
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21394
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21395
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21396
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 21397
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21398
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21399
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21400
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28