CMS Formulary

Displaying 113321-113330 of 1611142 results.
ID: 113321
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113322
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113323
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 795918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113324
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113325
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113326
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 996097
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113327
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113328
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113329
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113330
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30