CMS Formulary

Displaying 19951-19960 of 1611142 results.
ID: 19951
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19952
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 19953
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 19954
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19955
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19956
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19957
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19958
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19959
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 19960
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30