CMS Formulary

Displaying 117791-117800 of 1611142 results.
ID: 117791
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117792
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117793
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117794
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117795
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117796
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117797
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117798
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117799
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 117800
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30