CMS Formulary

Displaying 20381-20390 of 1611142 results.
ID: 20381
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20382
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20383
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20384
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20385
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20386
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20387
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20388
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20389
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20390
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0