CMS Formulary

Displaying 112931-112940 of 1611142 results.
ID: 112931
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 112932
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 884535
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 112933
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 884532
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 112934
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 112935
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 112936
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 112937
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 112938
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112939
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112940
Formulary ID: 00021043
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0