CMS Formulary

Displaying 112161-112170 of 1611142 results.
ID: 112161
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859000
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112162
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 28
ID: 112163
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 112164
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923338
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112165
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112166
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876406
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112167
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2375329
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112168
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112169
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003757
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112170
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003767
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0