CMS Formulary

Displaying 115831-115840 of 1611142 results.
ID: 115831
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115832
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 115833
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115834
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115835
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115836
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 115837
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115838
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 115839
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115840
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0