CMS Formulary

Displaying 1-10 of 1611142 results.
ID: 1
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 2
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 3
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 4
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 6
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 7
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 8
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 9
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 10
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30