CMS Formulary

Displaying 112611-112620 of 1611142 results.
ID: 112611
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 112612
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 112613
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 112614
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 112615
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 112616
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 112617
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 112618
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 112619
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 112620
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28