CMS Formulary

Displaying 921-930 of 1611142 results.
ID: 921
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 922
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 923
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 924
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 925
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 926
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 927
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 928
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 929
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 930
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0