CMS Formulary

Displaying 110311-110320 of 1611142 results.
ID: 110311
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110312
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 110313
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 110314
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110315
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 110316
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 110317
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 110318
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110319
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110320
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30