CMS Formulary

Displaying 110101-110110 of 1611142 results.
ID: 110101
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110102
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110103
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110104
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110105
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110106
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110107
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110108
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110109
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 110110
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0