CMS Formulary

Displaying 18811-18820 of 1611142 results.
ID: 18811
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18812
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18813
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 18814
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 18815
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18816
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18817
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18818
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 18819
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 18820
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0