CMS Formulary

Displaying 2821-2830 of 1611142 results.
ID: 2821
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 2822
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2823
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2824
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2825
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 2826
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 2827
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 2828
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 2829
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257015
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 2830
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30