CMS Formulary

Displaying 19541-19550 of 1611142 results.
ID: 19541
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19542
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19543
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19544
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19545
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19546
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19547
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19548
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19549
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19550
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0