CMS Formulary

Displaying 19501-19510 of 1611142 results.
ID: 19501
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 19502
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19503
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19504
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19505
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 19506
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 19507
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 19508
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19509
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19510
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0