CMS Formulary

Displaying 701-710 of 1611142 results.
ID: 701
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 702
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 703
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 704
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 705
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 706
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 707
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 708
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 709
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 710
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0