CMS Formulary

Displaying 118451-118460 of 1611142 results.
ID: 118451
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118452
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118453
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118454
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118455
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 483427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118456
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 483425
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118457
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118458
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118459
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118460
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0