CMS Formulary

Displaying 117481-117490 of 1611142 results.
ID: 117481
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117482
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117483
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117484
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117485
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117486
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1943345
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117487
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117488
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 117489
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117490
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0