CMS Formulary

Displaying 641-650 of 1611142 results.
ID: 641
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 642
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 643
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 644
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 645
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 646
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 647
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 648
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 904571
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 649
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 904583
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 650
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 904593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0