CMS Formulary

Displaying 100311-100320 of 1611142 results.
ID: 100311
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100312
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360548
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100313
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100314
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100315
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100316
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100317
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100318
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100319
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100320
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30