CMS Formulary

Displaying 581-590 of 1611142 results.
ID: 581
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 582
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 583
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197392
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 584
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 597852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 585
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 597850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 586
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 310273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 587
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 588
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 589
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 866049
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 590
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896019
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30