CMS Formulary

Displaying 110791-110800 of 1611142 results.
ID: 110791
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110792
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110793
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 999986
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110794
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110795
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110796
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110797
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110798
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110799
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110800
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0