CMS Formulary

Displaying 115201-115210 of 1611142 results.
ID: 115201
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115202
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115203
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115204
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 616402
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 115205
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115206
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115207
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 835572
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115208
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 835591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115209
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 835577
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115210
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0