CMS Formulary

Displaying 111751-111760 of 1611142 results.
ID: 111751
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 111752
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 312504
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111753
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111754
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111755
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111756
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111757
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111758
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111759
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111760
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0