CMS Formulary

Displaying 21771-21780 of 1611142 results.
ID: 21771
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21772
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21773
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21774
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21775
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21776
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21777
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21778
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 21779
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21780
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30