CMS Formulary

Displaying 491-500 of 1611142 results.
ID: 491
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 492
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 493
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 494
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 495
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860151
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 496
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 497
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 498
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 499
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 500
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0