CMS Formulary

Displaying 116871-116880 of 1611142 results.
ID: 116871
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116872
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116873
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116874
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116875
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116876
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116877
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 116878
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116879
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116880
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28