CMS Formulary

Displaying 1671-1680 of 1611142 results.
ID: 1671
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 1672
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1673
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1674
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1675
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1676
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1677
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1678
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1679
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1680
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30