CMS Formulary

Displaying 19351-19360 of 1611142 results.
ID: 19351
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19352
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19353
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19354
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 19355
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19356
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19357
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19358
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 19359
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 19360
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30