CMS Formulary

Displaying 111571-111580 of 1611142 results.
ID: 111571
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044732
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111572
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111573
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111574
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111575
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111576
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111577
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111578
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111579
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111580
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0