CMS Formulary

Displaying 117491-117500 of 1611142 results.
ID: 117491
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117492
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 117493
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117494
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056748
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 117495
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117496
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 117497
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117498
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117499
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117500
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30