CMS Formulary

Displaying 118601-118610 of 1611142 results.
ID: 118601
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365
ID: 118602
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118603
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118604
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118605
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118606
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118607
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118608
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118609
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118610
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0