CMS Formulary

Displaying 111031-111040 of 1611142 results.
ID: 111031
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111032
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111033
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111034
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111035
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111036
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111037
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111038
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111039
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111040
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0