CMS Formulary

Displaying 111551-111560 of 1611142 results.
ID: 111551
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111552
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111553
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111554
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 111555
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111556
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111557
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111558
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111559
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 111560
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30