CMS Formulary

Displaying 116641-116650 of 1611142 results.
ID: 116641
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806193
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116642
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 116643
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116644
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116645
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116646
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 116647
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 116648
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 116649
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116650
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0