CMS Formulary

Displaying 113081-113090 of 1611142 results.
ID: 113081
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 750267
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113082
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095229
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113083
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 857560
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113084
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113085
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113086
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113087
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113088
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113089
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113090
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30