CMS Formulary

Displaying 118861-118870 of 1611142 results.
ID: 118861
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118862
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 854894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118863
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 854880
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118864
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118865
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118866
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118867
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 602635
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118868
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118869
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118870
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0