CMS Formulary

Displaying 21521-21530 of 1611142 results.
ID: 21521
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21522
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21523
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21524
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099686
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 21525
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099691
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 21526
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099697
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 21527
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21528
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21529
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21530
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0