CMS Formulary

Displaying 611-620 of 1611142 results.
ID: 611
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 612
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2109239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 613
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 614
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 615
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 616
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 617
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 618
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 619
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 620
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0