CMS Formulary

Displaying 19261-19270 of 1611142 results.
ID: 19261
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 19262
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 19263
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19264
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19265
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19266
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19267
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19268
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 19269
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 19270
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111642
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30