CMS Formulary

Displaying 114081-114090 of 1611142 results.
ID: 114081
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 114082
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 84
ID: 114083
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114084
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114085
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 114086
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114087
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114088
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 795085
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114089
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 849599
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114090
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30