CMS Formulary

Displaying 114881-114890 of 1611142 results.
ID: 114881
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114882
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114883
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114884
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 114885
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114886
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442681
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114887
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442683
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114888
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114889
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101465
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114890
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1926823
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30