CMS Formulary

Displaying 114501-114510 of 1611142 results.
ID: 114501
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 114502
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 114503
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 114504
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 114505
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 114506
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 114507
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 114508
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114509
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114510
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30