CMS Formulary

Displaying 118801-118810 of 1611142 results.
ID: 118801
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118802
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118803
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118804
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118805
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118806
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118807
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118808
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30
ID: 118809
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30
ID: 118810
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0