CMS Formulary

Displaying 116971-116980 of 1611142 results.
ID: 116971
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116972
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116973
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977939
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116974
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977942
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 116975
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116976
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116977
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116978
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116979
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116980
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0