CMS Formulary

Displaying 110041-110050 of 1611142 results.
ID: 110041
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110042
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110043
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110044
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110045
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 110046
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 110047
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 153822
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110048
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110049
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110050
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0