CMS Formulary

Displaying 1781-1790 of 1611142 results.
ID: 1781
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1782
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242819
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 1783
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 56
ID: 1784
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1785
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1786
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1787
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1788
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1789
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1790
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30