CMS Formulary

Displaying 117041-117050 of 1611142 results.
ID: 117041
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117042
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117043
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117044
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117045
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117046
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117047
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117048
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117049
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117050
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30