CMS Formulary

Displaying 111351-111360 of 1611142 results.
ID: 111351
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111352
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111353
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111354
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111355
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 111356
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111357
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 111358
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 111359
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 111360
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28