CMS Formulary

Displaying 114311-114320 of 1611142 results.
ID: 114311
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114312
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 994005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114313
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114314
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114315
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114316
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114317
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114318
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114319
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 114320
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0