CMS Formulary

Displaying 111721-111730 of 1611142 results.
ID: 111721
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111722
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 111723
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 111724
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111725
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111726
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111727
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111728
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111729
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111730
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0