CMS Formulary

Displaying 117801-117810 of 1611142 results.
ID: 117801
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117802
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117803
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117804
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 700408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117805
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 117806
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197654
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117807
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117808
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 238153
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 117809
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117810
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0