CMS Formulary

Displaying 117371-117380 of 1611142 results.
ID: 117371
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 117372
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117373
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117374
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117375
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117376
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117377
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 597967
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117378
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 597980
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117379
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 597974
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117380
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 597987
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0