CMS Formulary

Displaying 891-900 of 1611142 results.
ID: 891
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 892
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 893
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 894
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 895
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 896
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 897
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 898
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 899
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 900
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30