CMS Formulary

Displaying 116011-116020 of 1611142 results.
ID: 116011
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116012
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116013
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116014
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116015
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116016
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116017
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116018
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 116019
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 116020
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0