CMS Formulary

Displaying 117781-117790 of 1611142 results.
ID: 117781
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 834348
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117782
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370767
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117783
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117784
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117785
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117786
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370770
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 117787
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117788
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117789
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117790
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0