CMS Formulary

Displaying 20631-20640 of 1611142 results.
ID: 20631
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20632
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20633
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20634
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20635
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20636
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20637
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20638
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 20639
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 20640
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30