CMS Formulary

Displaying 19251-19260 of 1611142 results.
ID: 19251
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19252
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19253
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19254
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19255
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19256
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19257
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19258
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19259
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 19260
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0