CMS Formulary

Displaying 1361-1370 of 1611142 results.
ID: 1361
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 1362
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 1363
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1364
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1365
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1366
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1367
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 897666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1368
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1369
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1370
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0