CMS Formulary

Displaying 112781-112790 of 1611142 results.
ID: 112781
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 801000
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112782
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 801021
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112783
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 801031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112784
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112785
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 112786
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 112787
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 856720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112788
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112789
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112790
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0