CMS Formulary

Displaying 20911-20920 of 1611142 results.
ID: 20911
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20912
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20913
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20914
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20915
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20916
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 20917
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 20918
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 20919
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20920
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0