CMS Formulary

Displaying 116361-116370 of 1611142 results.
ID: 116361
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 116362
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 116363
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 116364
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116365
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116366
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116367
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116368
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 116369
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 116370
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28