CMS Formulary

Displaying 113821-113830 of 1611142 results.
ID: 113821
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244634
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113822
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113823
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113824
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 113825
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113826
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113827
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113828
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113829
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797895
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113830
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0