CMS Formulary

Displaying 19701-19710 of 1611142 results.
ID: 19701
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19702
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 19703
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 19704
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 315187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19705
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 856724
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19706
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 856733
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19707
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19708
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197577
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19709
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 343033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19710
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197579
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0