CMS Formulary

Displaying 18771-18780 of 1611142 results.
ID: 18771
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 18772
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 18773
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 18774
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 18775
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18776
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18777
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 18778
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18779
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18780
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30