CMS Formulary

Displaying 111121-111130 of 1611142 results.
ID: 111121
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111122
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111123
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111124
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111125
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111126
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111127
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111128
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111129
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 854868
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111130
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001564
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30