CMS Formulary

Displaying 261-270 of 1611142 results.
ID: 261
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 262
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 263
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 264
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 265
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 266
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 267
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 268
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 269
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 270
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0