CMS Formulary

Displaying 117011-117020 of 1611142 results.
ID: 117011
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117012
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117013
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117014
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091155
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117015
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091170
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117016
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091185
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117017
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091210
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117018
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117019
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 117020
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30