CMS Formulary

Displaying 19781-19790 of 1611142 results.
ID: 19781
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19782
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19783
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19784
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19785
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 19786
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19787
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 19788
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 19789
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 19790
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0