CMS Formulary

Displaying 1701-1710 of 1611142 results.
ID: 1701
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1702
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1703
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1704
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1705
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 1706
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 1707
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1708
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 1709
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 1710
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28