CMS Formulary

Displaying 200371-200380 of 1611142 results.
ID: 200371
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 200372
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 200373
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 14
ID: 200374
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 14
ID: 200375
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 14
ID: 200376
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 903847
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200377
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200378
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 200379
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 200380
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0