CMS Formulary

Displaying 111261-111270 of 1611142 results.
ID: 111261
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 111262
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 111263
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 111264
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111265
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111266
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111267
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111268
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111269
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111270
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30