CMS Formulary

Displaying 115001-115010 of 1611142 results.
ID: 115001
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115002
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115003
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115004
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115005
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115006
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115007
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115008
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115009
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 115010
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30