CMS Formulary

Displaying 1131-1140 of 1611142 results.
ID: 1131
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1132
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1133
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1134
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1135
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1136
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 828755
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1137
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 828539
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1138
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1139
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 645884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1140
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28