CMS Formulary

Displaying 20771-20780 of 1611142 results.
ID: 20771
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20772
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20773
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20774
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20775
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 20776
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20777
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20778
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20779
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20780
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0