CMS Formulary

Displaying 116981-116990 of 1611142 results.
ID: 116981
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116982
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116983
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116984
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116985
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116986
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116987
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116988
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116989
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116990
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0