CMS Formulary

Displaying 117261-117270 of 1611142 results.
ID: 117261
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117262
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117263
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117264
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117265
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117266
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117267
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117268
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117269
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 117270
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28