CMS Formulary

Displaying 115731-115740 of 1611142 results.
ID: 115731
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 115732
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115733
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115734
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115735
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 830263
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115736
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658150
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115737
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055815
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115738
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115739
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115740
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1008
Qty Limit Days: 90