CMS Formulary

Displaying 441-450 of 1611142 results.
ID: 441
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 442
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 443
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 444
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 445
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 446
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 447
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 448
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 449
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 450
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30