CMS Formulary

Displaying 21921-21930 of 1611142 results.
ID: 21921
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 21922
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 21923
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21924
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21925
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 21926
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 21927
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 21928
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 21929
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 21930
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0