CMS Formulary

Displaying 117061-117070 of 1611142 results.
ID: 117061
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117062
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117063
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117064
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117065
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117066
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117067
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117068
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117069
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117070
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0