CMS Formulary

Displaying 691-700 of 1611142 results.
ID: 691
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 692
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 693
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 694
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 695
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 696
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 697
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 698
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 699
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 700
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30