CMS Formulary

Displaying 551-560 of 1611142 results.
ID: 551
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 552
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 553
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311033
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 554
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311027
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 555
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 556
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 557
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 558
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 559
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 560
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28