CMS Formulary

Displaying 118651-118660 of 1611142 results.
ID: 118651
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 433801
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 118652
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118653
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118654
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118655
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118656
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118657
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118658
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118659
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118660
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0