CMS Formulary

Displaying 117831-117840 of 1611142 results.
ID: 117831
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 994239
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 117832
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117833
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012904
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117834
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117835
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 117836
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 117837
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 117838
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117839
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117840
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0