CMS Formulary

Displaying 681-690 of 1611142 results.
ID: 681
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 682
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 683
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 684
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 685
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 686
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 687
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 688
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 689
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 690
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30