CMS Formulary

Displaying 230711-230720 of 1611142 results.
ID: 230711
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 313888
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230712
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 309042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230713
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 808118
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230714
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230715
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230716
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230717
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 230718
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230719
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230720
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0