CMS Formulary

Displaying 114351-114360 of 1611142 results.
ID: 114351
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114352
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114353
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114354
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180
ID: 114355
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114356
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114357
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114358
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114359
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 114360
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2120195
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30