CMS Formulary

Displaying 116961-116970 of 1611142 results.
ID: 116961
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 116962
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 116963
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116964
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 116965
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116966
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116967
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116968
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116969
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116970
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30