CMS Formulary

Displaying 116941-116950 of 1611142 results.
ID: 116941
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116942
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116943
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116944
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116945
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116946
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116947
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116948
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310992
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116949
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116950
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0