CMS Formulary

Displaying 20781-20790 of 1611142 results.
ID: 20781
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20782
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20783
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20784
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20785
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20786
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20787
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 20788
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 20789
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20790
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0