CMS Formulary

Displaying 113611-113620 of 1611142 results.
ID: 113611
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113612
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113613
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113614
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113615
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113616
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113617
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113618
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 113619
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 113620
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0