CMS Formulary

Displaying 20681-20690 of 1611142 results.
ID: 20681
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20682
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20683
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20684
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20685
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 20686
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20687
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20688
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20689
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20690
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0