CMS Formulary

Displaying 113881-113890 of 1611142 results.
ID: 113881
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113882
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056748
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 113883
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 113884
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 113885
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113886
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113887
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113888
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 113889
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113890
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167575
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30