CMS Formulary

Displaying 112061-112070 of 1611142 results.
ID: 112061
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 112062
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 112063
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 112064
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112065
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 112066
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112067
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112068
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112069
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112070
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30