CMS Formulary

Displaying 19271-19280 of 1611142 results.
ID: 19271
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 19272
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 19273
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19274
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19275
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19276
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 19277
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19278
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 19279
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19280
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0