CMS Formulary

Displaying 561-570 of 1611142 results.
ID: 561
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 562
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 563
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 564
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 565
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 566
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 567
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 568
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 569
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 570
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30