CMS Formulary

Displaying 1681-1690 of 1611142 results.
ID: 1681
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 1682
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 1683
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 1684
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 180
ID: 1685
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 1686
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1687
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1688
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055650
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 1689
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1690
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0