CMS Formulary

Displaying 118521-118530 of 1611142 results.
ID: 118521
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118522
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118523
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 118524
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 118525
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 118526
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118527
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118528
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118529
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118530
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30