CMS Formulary

Displaying 241-250 of 1611142 results.
ID: 241
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 242
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 243
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 244
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 245
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 246
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 247
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 248
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 249
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 250
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0