CMS Formulary

Displaying 391-400 of 1611142 results.
ID: 391
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 392
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 393
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 394
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 395
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 396
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 397
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 398
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 399
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 894859
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 400
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0