CMS Formulary

Displaying 115531-115540 of 1611142 results.
ID: 115531
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 115532
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 115533
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115534
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1927682
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14
ID: 115535
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115536
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115537
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115538
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115539
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115540
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0