CMS Formulary

Displaying 210411-210420 of 1611142 results.
ID: 210411
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210412
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210413
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210414
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210415
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210416
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210417
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210418
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210419
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 210420
Formulary ID: 00021091
Formulary Version: 13
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0