CMS Formulary

Displaying 110131-110140 of 1611142 results.
ID: 110131
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110132
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110133
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1423080
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110134
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110135
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110136
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110137
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110138
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110139
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110140
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0