CMS Formulary

Displaying 114191-114200 of 1611142 results.
ID: 114191
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114192
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 700408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114193
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 114194
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197654
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114195
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114196
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 238153
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 114197
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114198
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114199
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 835956
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114200
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0