CMS Formulary

Displaying 8451-8460 of 1611142 results.
ID: 8451
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8452
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8453
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8454
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8455
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8456
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8457
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8458
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8459
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 8460
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30