CMS Formulary

Displaying 621-630 of 1611142 results.
ID: 621
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 622
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 623
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 624
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 625
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 626
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 627
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 628
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 629
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 630
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30