CMS Formulary

Displaying 115061-115070 of 1611142 results.
ID: 115061
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115062
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115063
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115064
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115065
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115066
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115067
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 115068
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115069
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115070
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0