CMS Formulary

Displaying 114231-114240 of 1611142 results.
ID: 114231
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114232
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114233
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114234
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114235
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114236
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114237
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114238
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114239
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114240
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0