CMS Formulary

Displaying 9231-9240 of 1611142 results.
ID: 9231
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9232
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9233
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9234
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9235
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 860707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9236
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9237
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9238
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9239
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9240
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30