CMS Formulary

Displaying 114641-114650 of 1611142 results.
ID: 114641
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114642
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114643
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114644
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114645
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114646
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114647
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114648
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114649
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114650
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0