CMS Formulary

Displaying 118691-118700 of 1611142 results.
ID: 118691
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118692
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 419849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118693
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118694
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118695
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118696
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118697
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118698
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118699
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118700
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 730869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0