CMS Formulary

Displaying 113181-113190 of 1611142 results.
ID: 113181
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113182
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113183
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113184
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113185
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113186
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113187
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113188
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113189
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113190
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0