CMS Formulary

Displaying 116271-116280 of 1611142 results.
ID: 116271
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 116272
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116273
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116274
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116275
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116276
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 116277
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116278
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116279
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116280
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2109239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0