CMS Formulary

Displaying 117501-117510 of 1611142 results.
ID: 117501
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117502
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167575
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117503
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117504
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117505
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117506
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117507
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117508
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117509
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117510
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30