CMS Formulary

Displaying 112861-112870 of 1611142 results.
ID: 112861
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112862
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112863
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112864
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 112865
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112866
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 112867
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 112868
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 112869
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 112870
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 198296
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0