CMS Formulary

Displaying 11-20 of 1611142 results.
ID: 11
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047247
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256947
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 13
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 14
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256943
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 15
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205474
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 16
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 17
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 18
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 19
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 207834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 20
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28