CMS Formulary

Displaying 19171-19180 of 1611142 results.
ID: 19171
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19172
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19173
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19174
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19175
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19176
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19177
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19178
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19179
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19180
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0