CMS Formulary

Displaying 113831-113840 of 1611142 results.
ID: 113831
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113832
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113833
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 113834
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 19
Qty Limit Days: 30
ID: 113835
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113836
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113837
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113838
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 113839
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 113840
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30