CMS Formulary

Displaying 112341-112350 of 1611142 results.
ID: 112341
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 112342
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112343
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112344
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 112345
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 845518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 112346
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 112347
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112348
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 860244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 112349
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 112350
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28