CMS Formulary

Displaying 2771-2780 of 1611142 results.
ID: 2771
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 349592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 2772
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 349593
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 2773
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011736
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2774
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2775
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2776
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2777
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2778
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 2779
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 2780
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30