CMS Formulary

Displaying 21611-21620 of 1611142 results.
ID: 21611
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21612
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21613
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21614
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 21615
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21616
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21617
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21618
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21619
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21620
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0