CMS Formulary

Displaying 114891-114900 of 1611142 results.
ID: 114891
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1926827
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 114892
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809513
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114893
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114894
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114895
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876674
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114896
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114897
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114898
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114899
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 114900
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28