CMS Formulary

Displaying 20391-20400 of 1611142 results.
ID: 20391
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20392
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20393
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20394
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20395
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20396
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20397
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20398
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20399
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20400
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30