CMS Formulary

Displaying 2241-2250 of 1611142 results.
ID: 2241
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2242
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2243
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2244
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2245
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 2246
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 2247
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 2248
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 2249
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2250
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0