CMS Formulary

Displaying 51-60 of 1611142 results.
ID: 51
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 55
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 57
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 58
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 60
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30