CMS Formulary

Displaying 251-260 of 1611142 results.
ID: 251
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 252
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 253
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 254
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 255
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 256
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 257
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 258
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 259
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 260
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30