CMS Formulary

Displaying 117091-117100 of 1611142 results.
ID: 117091
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117092
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117093
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 863628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117094
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314080
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117095
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190655
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117096
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 545236
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117097
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117098
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244616
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117099
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117100
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 308345
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0