CMS Formulary

Displaying 113711-113720 of 1611142 results.
ID: 113711
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113712
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113713
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113714
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113715
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113716
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113717
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113718
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113719
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113720
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30