CMS Formulary

Displaying 117571-117580 of 1611142 results.
ID: 117571
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117572
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117573
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117574
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117575
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117576
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117577
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117578
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117579
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117580
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198056
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0