CMS Formulary

Displaying 31-40 of 1611142 results.
ID: 31
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 32
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 33
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 35
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 36
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0