CMS Formulary

Displaying 114911-114920 of 1611142 results.
ID: 114911
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 114912
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 114913
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 114914
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114915
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114916
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114917
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114918
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114919
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 114920
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30