CMS Formulary

Displaying 9471-9480 of 1611142 results.
ID: 9471
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9472
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9473
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9474
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9475
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9476
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9477
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 9478
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9479
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9480
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30