CMS Formulary

Displaying 361-370 of 1611142 results.
ID: 361
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 362
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 363
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 364
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 365
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 366
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 367
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 368
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 369
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 370
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0