CMS Formulary

Displaying 1381-1390 of 1611142 results.
ID: 1381
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1382
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25
ID: 1383
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 213262
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1384
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1385
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1386
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1387
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1388
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1389
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1390
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0