CMS Formulary

Displaying 115341-115350 of 1611142 results.
ID: 115341
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115342
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115343
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115344
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115345
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115346
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115347
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115348
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115349
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 115350
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30