CMS Formulary

Displaying 114631-114640 of 1611142 results.
ID: 114631
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114632
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114633
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114634
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 114635
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 114636
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 577208
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 114637
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114638
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114639
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114640
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0