CMS Formulary

Displaying 21831-21840 of 1611142 results.
ID: 21831
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21832
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21833
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 21834
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 21835
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 21836
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 21837
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 25
ID: 21838
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21839
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21840
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0