CMS Formulary

Displaying 19731-19740 of 1611142 results.
ID: 19731
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 19732
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 19733
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 19734
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19735
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19736
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19737
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19738
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19739
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19740
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28