CMS Formulary

Displaying 19771-19780 of 1611142 results.
ID: 19771
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 19772
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19773
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 19774
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19775
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 19776
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 19777
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19778
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19779
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 19780
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28