CMS Formulary

Displaying 1231-1240 of 1611142 results.
ID: 1231
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1232
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 1233
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1234
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1235
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1236
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 1237
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 1238
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 1239
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 1240
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30