CMS Formulary

Displaying 1981-1990 of 1611142 results.
ID: 1981
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 1982
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1983
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1984
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1985
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1986
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 1987
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1988
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1989
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 1990
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30