CMS Formulary

Displaying 110051-110060 of 1611142 results.
ID: 110051
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 578330
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110052
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 802749
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110053
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110054
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110055
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110056
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110057
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110058
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110059
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 110060
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0