CMS Formulary

Displaying 19481-19490 of 1611142 results.
ID: 19481
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19482
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19483
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 19484
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 19485
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 168
ID: 19486
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19487
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 19488
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19489
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19490
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 312
Qty Limit Days: 30