CMS Formulary

Displaying 111631-111640 of 1611142 results.
ID: 111631
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111632
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111633
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111634
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111635
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111636
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111637
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111638
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 854894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111639
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 854880
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111640
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0