CMS Formulary

Displaying 431-440 of 1611142 results.
ID: 431
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 432
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 433
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 434
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 435
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 436
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 437
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 438
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 439
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 440
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30