CMS Formulary

Displaying 112091-112100 of 1611142 results.
ID: 112091
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112092
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112093
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112094
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112095
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112096
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112097
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112098
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112099
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112100
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0