CMS Formulary

Displaying 111991-112000 of 1611142 results.
ID: 111991
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 111992
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 111993
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282320
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 111994
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 111995
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 111996
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 111997
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 111998
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 111999
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 112000
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2286261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0