CMS Formulary

Displaying 116831-116840 of 1611142 results.
ID: 116831
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116832
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116833
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 562251
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116834
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 617995
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116835
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116836
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116837
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116838
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 116839
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 116840
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30