CMS Formulary

Displaying 118531-118540 of 1611142 results.
ID: 118531
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118532
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 118533
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118534
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118535
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118536
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 118537
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 118538
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118539
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118540
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0