CMS Formulary

Displaying 112081-112090 of 1611142 results.
ID: 112081
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112082
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112083
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 352297
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112084
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112085
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112086
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112087
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112088
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112089
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 112090
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30