CMS Formulary

Displaying 21851-21860 of 1611142 results.
ID: 21851
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21852
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21853
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21854
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21855
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21856
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21857
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21858
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21859
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21860
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0