CMS Formulary

Displaying 118241-118250 of 1611142 results.
ID: 118241
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118242
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118243
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118244
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118245
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118246
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 118247
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 118248
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 577208
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 118249
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118250
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30