CMS Formulary

Displaying 116531-116540 of 1611142 results.
ID: 116531
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116532
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116533
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116534
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116535
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116536
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116537
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116538
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116539
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116540
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30