CMS Formulary

Displaying 114091-114100 of 1611142 results.
ID: 114091
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114092
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114093
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114094
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114095
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114096
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114097
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 114098
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 114099
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114100
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 7