CMS Formulary

Displaying 110071-110080 of 1611142 results.
ID: 110071
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110072
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110073
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 110074
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110075
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110076
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110077
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110078
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110079
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110080
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0