CMS Formulary

Displaying 111311-111320 of 1611142 results.
ID: 111311
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111312
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 111313
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 111314
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111315
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111316
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111317
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111318
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111319
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111320
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0