CMS Formulary

Displaying 114211-114220 of 1611142 results.
ID: 114211
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114212
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114213
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114214
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114215
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653433
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114216
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114217
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114218
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 993943
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 114219
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 994239
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 114220
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0