CMS Formulary

Displaying 931-940 of 1611142 results.
ID: 931
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806187
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 932
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 933
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806191
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 934
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806193
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 935
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 905369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 936
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 937
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 938
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 939
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 940
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30