CMS Formulary

Displaying 114241-114250 of 1611142 results.
ID: 114241
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 114242
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 114243
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114244
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114245
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114246
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114247
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115012
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 114248
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115013
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 114249
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114250
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0