CMS Formulary

Displaying 111341-111350 of 1611142 results.
ID: 111341
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111342
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111343
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 111344
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111345
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 111346
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 312085
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111347
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111348
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30
ID: 111349
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111350
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0