CMS Formulary

Displaying 118781-118790 of 1611142 results.
ID: 118781
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118782
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118783
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 118784
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 118785
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118786
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118787
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118788
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 118789
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 118790
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30