CMS Formulary

Displaying 110111-110120 of 1611142 results.
ID: 110111
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110112
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110113
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110114
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110115
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110116
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856987
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 110117
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856992
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 110118
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110119
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 110120
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30