CMS Formulary

Displaying 110521-110530 of 1611142 results.
ID: 110521
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110522
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 315059
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 110523
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110524
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110525
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110526
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110527
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110528
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110529
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110530
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0