CMS Formulary

Displaying 117641-117650 of 1611142 results.
ID: 117641
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 117642
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117643
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 117644
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117645
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117646
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117647
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117648
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 117649
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 117650
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180