CMS Formulary

Displaying 111301-111310 of 1611142 results.
ID: 111301
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 111302
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 977923
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111303
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 977929
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111304
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111305
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111306
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111307
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111308
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111309
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111310
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0