CMS Formulary

Displaying 19421-19430 of 1611142 results.
ID: 19421
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 19422
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 19423
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19424
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19425
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19426
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19427
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19428
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19429
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19430
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0