CMS Formulary

Displaying 111701-111710 of 1611142 results.
ID: 111701
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111702
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111703
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111704
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111705
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111706
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 284201
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 111707
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 351134
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 111708
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 314142
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 111709
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 111710
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0