CMS Formulary

Displaying 230301-230310 of 1611142 results.
ID: 230301
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230302
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230303
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 996572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230304
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230305
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230306
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230307
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230308
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230309
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230310
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0