CMS Formulary

Displaying 1221-1230 of 1611142 results.
ID: 1221
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 1222
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 1223
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1224
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1225
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1226
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 1227
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1228
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006122
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1229
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 1230
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30