CMS Formulary

Displaying 18221-18230 of 1611142 results.
ID: 18221
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18222
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18223
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 18224
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 18225
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 18226
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18227
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18228
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18229
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18230
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0