CMS Formulary

Displaying 118921-118930 of 1611142 results.
ID: 118921
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118922
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118923
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 118924
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118925
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118926
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118927
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118928
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118929
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118930
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 284201
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30