CMS Formulary

Displaying 118621-118630 of 1611142 results.
ID: 118621
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 118622
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 118623
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 118624
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 118625
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310796
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118626
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118627
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310809
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118628
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118629
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 312086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118630
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0