CMS Formulary

Displaying 117351-117360 of 1611142 results.
ID: 117351
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117352
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117353
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117354
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117355
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117356
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117357
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1423080
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117358
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117359
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117360
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0