CMS Formulary

Displaying 1291-1300 of 1611142 results.
ID: 1291
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1292
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1293
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1294
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1295
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1296
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1297
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1298
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1299
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1300
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0