CMS Formulary

Displaying 21821-21830 of 1611142 results.
ID: 21821
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21822
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21823
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21824
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21825
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21826
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21827
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21828
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 21829
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21830
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0