CMS Formulary

Displaying 801-810 of 1611142 results.
ID: 801
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 802
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 803
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 804
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 805
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 806
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 807
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 808
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 809
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 810
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0