CMS Formulary

Displaying 1151-1160 of 1611142 results.
ID: 1151
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1152
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1153
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1154
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1155
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 1156
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1157
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 1158
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 1159
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 1160
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28