CMS Formulary

Displaying 111651-111660 of 1611142 results.
ID: 111651
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111652
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1485332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111653
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111654
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111655
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111656
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111657
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599949
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 111658
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111659
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 141850
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 111660
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197573
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30