CMS Formulary

Displaying 9971-9980 of 1611142 results.
ID: 9971
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 9972
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9973
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 9974
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243014
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 9975
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 9976
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 9977
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 9978
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9979
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9980
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30