CMS Formulary

Displaying 117361-117370 of 1611142 results.
ID: 117361
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117362
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117363
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117364
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117365
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117366
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117367
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117368
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117369
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117370
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0