CMS Formulary

Displaying 111231-111240 of 1611142 results.
ID: 111231
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 483427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111232
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 483425
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111233
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111234
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111235
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111236
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111237
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 111238
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111239
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111240
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0