CMS Formulary

Displaying 19471-19480 of 1611142 results.
ID: 19471
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 19472
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282320
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 19473
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 19474
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 19475
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 19476
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 19477
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19478
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19479
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19480
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30