CMS Formulary

Displaying 20761-20770 of 1611142 results.
ID: 20761
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20762
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20763
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20764
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20765
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20766
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20767
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20768
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20769
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20770
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30