CMS Formulary

Displaying 112011-112020 of 1611142 results.
ID: 112011
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112012
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112013
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 312
Qty Limit Days: 30
ID: 112014
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112015
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112016
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 112017
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112018
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112019
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 112020
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0