CMS Formulary

Displaying 111741-111750 of 1611142 results.
ID: 111741
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111742
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111743
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111744
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111745
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111746
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 111747
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111748
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111749
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111750
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0