CMS Formulary

Displaying 21841-21850 of 1611142 results.
ID: 21841
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21842
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21843
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21844
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 21845
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 21846
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 577208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 21847
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21848
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21849
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21850
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0