CMS Formulary

Displaying 21461-21470 of 1611142 results.
ID: 21461
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21462
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21463
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21464
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21465
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21466
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21467
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21468
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21469
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21470
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0