CMS Formulary

Displaying 811-820 of 1611142 results.
ID: 811
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 812
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 813
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 814
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 815
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 816
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 817
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 818
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 819
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 820
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30