CMS Formulary

Displaying 115231-115240 of 1611142 results.
ID: 115231
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 199352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115232
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115233
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115234
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115235
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115236
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 853201
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 115237
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115238
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115239
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115240
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 180