CMS Formulary

Displaying 117291-117300 of 1611142 results.
ID: 117291
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117292
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 117293
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117294
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117295
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117296
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117297
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 117298
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117299
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117300
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0