CMS Formulary

Displaying 831-840 of 1611142 results.
ID: 831
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 832
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 833
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 834
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 835
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 836
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 837
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 838
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 839
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 840
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30