CMS Formulary

Displaying 871-880 of 1611142 results.
ID: 871
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 872
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 873
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 874
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 875
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 876
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 877
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 878
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 879
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 880
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0