CMS Formulary

Displaying 111081-111090 of 1611142 results.
ID: 111081
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111082
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111083
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111084
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111085
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111086
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111087
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111088
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111089
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111090
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0