CMS Formulary

Displaying 116621-116630 of 1611142 results.
ID: 116621
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116622
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116623
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116624
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116625
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116626
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116627
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 116628
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116629
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116630
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0