CMS Formulary

Displaying 118301-118310 of 1611142 results.
ID: 118301
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118302
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118303
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118304
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118305
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118306
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118307
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118308
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118309
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118310
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0