CMS Formulary

Displaying 115191-115200 of 1611142 results.
ID: 115191
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115192
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115193
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115194
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115195
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115196
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30
ID: 115197
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30
ID: 115198
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115199
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115200
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0