CMS Formulary

Displaying 113861-113870 of 1611142 results.
ID: 113861
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113862
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113863
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113864
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 113865
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113866
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113867
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113868
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113869
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113870
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0