CMS Formulary

Displaying 661-670 of 1611142 results.
ID: 661
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 662
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 663
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 664
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 665
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 666
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 667
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 668
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 669
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 670
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0