CMS Formulary

Displaying 111381-111390 of 1611142 results.
ID: 111381
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111382
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111383
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111384
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111385
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111386
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111387
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111388
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111389
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111390
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0