CMS Formulary

Displaying 114391-114400 of 1611142 results.
ID: 114391
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114392
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114393
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114394
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114395
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114396
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114397
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114398
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114399
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114400
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30