CMS Formulary

Displaying 1181-1190 of 1611142 results.
ID: 1181
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1182
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 855300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1183
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809730
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1184
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809738
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1185
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1186
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 1187
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 1188
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 854238
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 1189
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 1190
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 854248
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30