CMS Formulary

Displaying 114981-114990 of 1611142 results.
ID: 114981
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 114982
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 114983
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 114984
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114985
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 114986
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 114987
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 114988
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 114989
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365
ID: 114990
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0