CMS Formulary

Displaying 113741-113750 of 1611142 results.
ID: 113741
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113742
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113743
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113744
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113745
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1423080
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113746
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113747
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113748
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113749
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113750
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30