CMS Formulary

Displaying 841-850 of 1611142 results.
ID: 841
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 842
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 843
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 844
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 845
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 846
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 847
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 848
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 849
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 850
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0