CMS Formulary

Displaying 119261-119270 of 1611142 results.
ID: 119261
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 119262
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 119263
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 119264
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 119265
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 119266
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119267
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 119268
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 119269
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119270
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30