CMS Formulary

Displaying 117111-117120 of 1611142 results.
ID: 117111
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117112
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117113
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117114
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117115
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 117116
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 117117
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117118
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117119
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117120
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0