CMS Formulary

Displaying 9711-9720 of 1611142 results.
ID: 9711
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 9712
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 28
ID: 9713
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 9714
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9715
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 9716
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282320
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 9717
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 9718
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 9719
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 9720
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28