CMS Formulary

Displaying 1051-1060 of 1611142 results.
ID: 1051
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 1052
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1053
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 28
ID: 1054
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 1055
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1056
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1057
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1058
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1059
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1060
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30