CMS Formulary

Displaying 111451-111460 of 1611142 results.
ID: 111451
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111452
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111453
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111454
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111455
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111456
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111457
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111458
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111459
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111460
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0