CMS Formulary

Displaying 117451-117460 of 1611142 results.
ID: 117451
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 117452
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 117453
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117454
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117455
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 117456
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117457
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117458
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197575
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117459
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117460
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30