CMS Formulary

Displaying 117341-117350 of 1611142 results.
ID: 117341
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 856992
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 117342
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117343
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117344
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117345
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117346
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117347
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117348
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117349
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117350
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0