CMS Formulary

Displaying 116931-116940 of 1611142 results.
ID: 116931
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116932
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116933
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116934
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116935
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 795918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116936
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116937
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116938
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 996097
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116939
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116940
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30