CMS Formulary

Displaying 114561-114570 of 1611142 results.
ID: 114561
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198108
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114562
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114563
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 114564
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114565
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114566
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114567
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114568
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114569
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114570
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349514
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30