CMS Formulary

Displaying 114321-114330 of 1611142 results.
ID: 114321
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114322
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114323
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114324
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114325
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114326
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114327
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114328
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114329
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 114330
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 994008
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30