CMS Formulary

Displaying 21481-21490 of 1611142 results.
ID: 21481
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21482
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21483
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21484
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21485
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21486
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21487
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21488
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21489
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21490
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0