CMS Formulary

Displaying 18701-18710 of 1611142 results.
ID: 18701
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18702
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18703
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 18704
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 18705
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18706
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18707
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18708
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18709
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 18710
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30