CMS Formulary

Displaying 9341-9350 of 1611142 results.
ID: 9341
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9342
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9343
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9344
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9345
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9346
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9347
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30
ID: 9348
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30
ID: 9349
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9350
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0