CMS Formulary

Displaying 201901-201910 of 1611142 results.
ID: 201901
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201902
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201903
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201904
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201905
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201906
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201907
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201908
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201909
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1365979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 201910
Formulary ID: 00021084
Formulary Version: 18
Contract Year: 2021
RXCUI: 1986331
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0