CMS Formulary

Displaying 771-780 of 1611142 results.
ID: 771
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 772
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 773
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 774
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 775
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 776
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 777
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 778
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 779
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 780
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30