CMS Formulary

Displaying 19561-19570 of 1611142 results.
ID: 19561
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19562
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19563
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19564
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19565
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19566
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19567
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19568
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19569
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19570
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0