CMS Formulary

Displaying 116741-116750 of 1611142 results.
ID: 116741
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116742
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116743
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116744
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 994237
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116745
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 857564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116746
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116747
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116748
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116749
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116750
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0