CMS Formulary

Displaying 117741-117750 of 1611142 results.
ID: 117741
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 904447
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 28
ID: 117742
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117743
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117744
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117745
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117746
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 315059
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117747
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117748
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117749
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117750
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0