CMS Formulary

Displaying 112891-112900 of 1611142 results.
ID: 112891
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 112892
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 112893
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112894
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112895
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112896
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112897
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112898
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112899
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112900
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 359697
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0