CMS Formulary

Displaying 1121-1130 of 1611142 results.
ID: 1121
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1122
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1123
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1124
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1125
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1126
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 1127
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 1128
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1129
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 1130
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0