CMS Formulary

Displaying 113971-113980 of 1611142 results.
ID: 113971
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 113972
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 113973
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 113974
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 113975
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113976
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113977
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 113978
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113979
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113980
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0