CMS Formulary

Displaying 113961-113970 of 1611142 results.
ID: 113961
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113962
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113963
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113964
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113965
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113966
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113967
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113968
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198056
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113969
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 351276
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113970
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 728207
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0