CMS Formulary

Displaying 671-680 of 1611142 results.
ID: 671
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 794639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 672
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 673
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 674
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 675
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 676
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 677
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 678
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 679
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 680
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28