CMS Formulary

Displaying 113261-113270 of 1611142 results.
ID: 113261
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113262
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113263
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113264
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113265
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 113266
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113267
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113268
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 113269
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 113270
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28