CMS Formulary

Displaying 112541-112550 of 1611142 results.
ID: 112541
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197737
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112542
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112543
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112544
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112545
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112546
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 112547
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112548
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 112549
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860151
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 112550
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30