CMS Formulary

Displaying 19181-19190 of 1611142 results.
ID: 19181
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 979092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19182
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19183
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19184
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19185
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19186
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19187
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19188
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19189
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19190
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30