CMS Formulary

Displaying 111971-111980 of 1611142 results.
ID: 111971
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 111972
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 111973
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 111974
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382990
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 111975
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178407
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 28
ID: 111976
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178409
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 111977
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 111978
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 111979
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272630
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111980
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0