CMS Formulary

Displaying 113481-113490 of 1611142 results.
ID: 113481
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 863628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113482
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314080
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113483
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190655
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113484
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 545236
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113485
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113486
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244616
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113487
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113488
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 308345
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113489
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197636
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113490
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0