CMS Formulary

Displaying 111781-111790 of 1611142 results.
ID: 111781
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 111782
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111783
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111784
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 111785
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111786
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111787
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370758
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 111788
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111789
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 111790
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0