CMS Formulary

Displaying 1611-1620 of 1611142 results.
ID: 1611
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122642
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1612
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1613
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1614
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1615
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1616
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1617
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1618
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1619
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1620
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0