CMS Formulary

Displaying 113011-113020 of 1611142 results.
ID: 113011
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113012
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113013
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113014
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 113015
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 113016
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113017
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113018
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113019
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113020
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30