CMS Formulary

Displaying 117931-117940 of 1611142 results.
ID: 117931
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 117932
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117933
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117934
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117935
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117936
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117937
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117938
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117939
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117940
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0