CMS Formulary

Displaying 591-600 of 1611142 results.
ID: 591
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896027
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 592
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896023
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 593
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 594
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 180
ID: 595
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 596
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 597
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 598
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 599
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 600
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30