CMS Formulary

Displaying 113651-113660 of 1611142 results.
ID: 113651
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113652
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113653
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113654
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113655
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113656
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113657
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 113658
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 113659
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 153822
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113660
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0