CMS Formulary

Displaying 110561-110570 of 1611142 results.
ID: 110561
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110562
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370770
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 110563
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110564
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110565
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110566
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110567
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110568
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110569
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110570
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0