CMS Formulary

Displaying 117851-117860 of 1611142 results.
ID: 117851
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117852
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117853
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 117854
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 117855
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117856
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117857
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117858
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117859
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115012
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 117860
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115013
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30