CMS Formulary

Displaying 21411-21420 of 1611142 results.
ID: 21411
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 21412
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21413
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 21414
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21415
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21416
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21417
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21418
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21419
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21420
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0