CMS Formulary

Displaying 521-530 of 1611142 results.
ID: 521
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 522
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 523
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 524
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 525
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 526
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 527
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 528
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 529
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 530
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0