CMS Formulary

Displaying 116861-116870 of 1611142 results.
ID: 116861
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 757968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116862
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 116863
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197411
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116864
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310600
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116865
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403850
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116866
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 810090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116867
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403851
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116868
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116869
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116870
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0