CMS Formulary

Displaying 117771-117780 of 1611142 results.
ID: 117771
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117772
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117773
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117774
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117775
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117776
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117777
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117778
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117779
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117780
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0