CMS Formulary

Displaying 118361-118370 of 1611142 results.
ID: 118361
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118362
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118363
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118364
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118365
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118366
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 118367
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118368
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118369
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118370
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0