CMS Formulary

Displaying 119251-119260 of 1611142 results.
ID: 119251
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119252
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 884077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119253
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 119254
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 119255
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 119256
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119257
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119258
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119259
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119260
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0