CMS Formulary

Displaying 171-180 of 1611142 results.
ID: 171
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 174
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1300
Qty Limit Days: 30
ID: 175
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 176
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 177
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 178
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 179
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 180
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0