CMS Formulary

Displaying 114521-114530 of 1611142 results.
ID: 114521
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 114522
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114523
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114524
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114525
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114526
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114527
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114528
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114529
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1052660
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114530
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1250723
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0