CMS Formulary

Displaying 19241-19250 of 1611142 results.
ID: 19241
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19242
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19243
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19244
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19245
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19246
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 19247
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312504
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19248
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19249
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19250
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0