CMS Formulary

Displaying 230011-230020 of 1611142 results.
ID: 230011
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230012
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230013
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230014
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 230015
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 230016
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 230017
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230018
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230019
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230020
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0