CMS Formulary

Displaying 21911-21920 of 1611142 results.
ID: 21911
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21912
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21913
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21914
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21915
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 21916
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 21917
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21918
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21919
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 21920
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28