CMS Formulary

Displaying 116181-116190 of 1611142 results.
ID: 116181
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116182
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116183
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116184
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116185
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2700
Qty Limit Days: 30
ID: 116186
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116187
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116188
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116189
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116190
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30