CMS Formulary

Displaying 113571-113580 of 1611142 results.
ID: 113571
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113572
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113573
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113574
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113575
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113576
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113577
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 113578
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 113579
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113580
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30