CMS Formulary

Displaying 115251-115260 of 1611142 results.
ID: 115251
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 854880
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 115252
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115253
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115254
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115255
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 602635
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115256
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115257
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115258
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115259
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115260
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0