CMS Formulary

Displaying 21781-21790 of 1611142 results.
ID: 21781
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21782
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21783
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21784
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21785
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21786
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21787
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21788
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 308459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21789
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 141963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21790
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84