CMS Formulary

Displaying 8341-8350 of 1611142 results.
ID: 8341
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 8342
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 8343
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 8344
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 8345
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 8346
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 8347
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 8348
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8349
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 8350
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84