CMS Formulary

Displaying 451-460 of 1611142 results.
ID: 451
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 452
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 453
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 454
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 455
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860157
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 456
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860129
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 457
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 458
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 459
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 460
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0