CMS Formulary

Displaying 791-800 of 1611142 results.
ID: 791
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 792
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 793
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 794
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 795
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 796
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 797
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 798
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 799
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 800
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30