CMS Formulary

Displaying 1191-1200 of 1611142 results.
ID: 1191
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 854245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 1192
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1193
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1194
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1195
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1196
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1197
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1198
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1199
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 1200
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30