CMS Formulary

Displaying 115051-115060 of 1611142 results.
ID: 115051
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115052
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115053
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 115054
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 115055
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115056
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115057
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115058
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115059
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115060
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0