CMS Formulary

Displaying 115211-115220 of 1611142 results.
ID: 115211
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115212
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115213
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115214
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115215
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115216
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115217
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 115218
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115219
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115220
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0