CMS Formulary

Displaying 117311-117320 of 1611142 results.
ID: 117311
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 117312
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 117313
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117314
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117315
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117316
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1542997
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 117317
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1432969
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 117318
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 904880
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 117319
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 117320
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30