CMS Formulary

Displaying 111-120 of 1611142 results.
ID: 111
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 112
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 113
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 114
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 115
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 118
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 119
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 120
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30