CMS Formulary

Displaying 2781-2790 of 1611142 results.
ID: 2781
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 2782
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 2783
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 2784
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 2785
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2786
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2787
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2788
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2789
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2790
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0