CMS Formulary

Displaying 110711-110720 of 1611142 results.
ID: 110711
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110712
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110713
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110714
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110715
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110716
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110717
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 110718
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 994008
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110719
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 900156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110720
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848582
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0