CMS Formulary

Displaying 115661-115670 of 1611142 results.
ID: 115661
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 115662
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256943
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 115663
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205474
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115664
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 115665
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946844
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 115666
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 115667
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 207834
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115668
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 115669
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115670
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 729234
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0