CMS Formulary

Displaying 117191-117200 of 1611142 results.
ID: 117191
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117192
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117193
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117194
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117195
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117196
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117197
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117198
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117199
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117200
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 856980
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30