CMS Formulary

Displaying 116711-116720 of 1611142 results.
ID: 116711
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116712
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116713
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116714
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 116715
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116716
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116717
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116718
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116719
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116720
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197653
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30