CMS Formulary

Displaying 117871-117880 of 1611142 results.
ID: 117871
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370763
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 118
Qty Limit Days: 30
ID: 117872
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117873
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117874
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117875
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806890
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117876
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2184126
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 117877
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117878
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 117879
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 117880
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30