CMS Formulary

Displaying 321-330 of 1611142 results.
ID: 321
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 322
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 323
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 324
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 325
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 326
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 327
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 328
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 329
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 330
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30