CMS Formulary

Displaying 112791-112800 of 1611142 results.
ID: 112791
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 112792
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 856840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112793
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112794
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112795
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112796
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112797
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112798
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112799
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 856769
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112800
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0