CMS Formulary

Displaying 112471-112480 of 1611142 results.
ID: 112471
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 112472
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112473
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112474
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112475
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112476
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112477
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112478
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 309960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112479
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 112480
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0