CMS Formulary

Displaying 120311-120320 of 1611142 results.
ID: 120311
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 753482
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120312
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 750268
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120313
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 761977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120314
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 750265
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120315
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 762001
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120316
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 762334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120317
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 753483
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120318
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 750267
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120319
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 801185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120320
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30