CMS Formulary

Displaying 21621-21630 of 1611142 results.
ID: 21621
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21622
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21623
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21624
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21625
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21626
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21627
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21628
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21629
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21630
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0