CMS Formulary

Displaying 117181-117190 of 1611142 results.
ID: 117181
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117182
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117183
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117184
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117185
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117186
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117187
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117188
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117189
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 117190
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30