CMS Formulary

Displaying 118991-119000 of 1611142 results.
ID: 118991
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 118992
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 118993
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118994
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118995
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118996
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118997
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053697
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118998
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 197849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118999
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119000
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30