CMS Formulary

Displaying 271-280 of 1611142 results.
ID: 271
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 272
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 273
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 274
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 275
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 276
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 277
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 278
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 279
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 280
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921010
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0