CMS Formulary

Displaying 21721-21730 of 1611142 results.
ID: 21721
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 21722
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 21723
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 21724
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 21725
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 21726
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21727
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21728
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21729
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 21730
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28