CMS Formulary

Displaying 116431-116440 of 1611142 results.
ID: 116431
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116432
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116433
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116434
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116435
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116436
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116437
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116438
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 116439
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 116440
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28