CMS Formulary

Displaying 311-320 of 1611142 results.
ID: 311
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 312
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1119402
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 313
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 314
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 315
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 316
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 317
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 318
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 319
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 320
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0