CMS Formulary

Displaying 117581-117590 of 1611142 results.
ID: 117581
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 351276
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117582
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 728207
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117583
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 117584
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 117585
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 117586
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117587
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117588
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117589
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 117590
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0