CMS Formulary

Displaying 118061-118070 of 1611142 results.
ID: 118061
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118062
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118063
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118064
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118065
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118066
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118067
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118068
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118069
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118070
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30