CMS Formulary

Displaying 113801-113810 of 1611142 results.
ID: 113801
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122655
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113802
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113803
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122648
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113804
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122642
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113805
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113806
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113807
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113808
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113809
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113810
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0