CMS Formulary

Displaying 118851-118860 of 1611142 results.
ID: 118851
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118852
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 180
ID: 118853
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 180
ID: 118854
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118855
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118856
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118857
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118858
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118859
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118860
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0