CMS Formulary

Displaying 140921-140930 of 1611142 results.
ID: 140921
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140922
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140923
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856792
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140924
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140925
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140926
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140927
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140928
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140929
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140930
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0