CMS Formulary

Displaying 117461-117470 of 1611142 results.
ID: 117461
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992273
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117462
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 477451
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 117463
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117464
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117465
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117466
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 117467
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117468
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117469
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117470
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0