CMS Formulary

Displaying 118121-118130 of 1611142 results.
ID: 118121
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118122
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 118123
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 118124
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 118125
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288433
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118126
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288412
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118127
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288431
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118128
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 118129
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 118130
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 7