CMS Formulary

Displaying 112531-112540 of 1611142 results.
ID: 112531
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 112532
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 112533
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 112534
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112535
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112536
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112537
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112538
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112539
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112540
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0