CMS Formulary

Displaying 118511-118520 of 1611142 results.
ID: 118511
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 118512
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 118513
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 118514
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118515
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118516
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118517
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 902624
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118518
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 902626
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118519
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118520
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30