CMS Formulary

Displaying 115991-116000 of 1611142 results.
ID: 115991
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 115992
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 115993
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 115994
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 115995
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115996
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115997
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 115998
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28
ID: 115999
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 116000
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0