CMS Formulary

Displaying 21701-21710 of 1611142 results.
ID: 21701
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 21702
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 21703
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21704
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21705
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21706
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21707
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21708
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21709
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21710
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30