CMS Formulary

Displaying 118381-118390 of 1611142 results.
ID: 118381
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118382
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118383
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118384
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118385
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118386
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118387
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049696
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 118388
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118389
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118390
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0