CMS Formulary

Displaying 110951-110960 of 1611142 results.
ID: 110951
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 110952
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110953
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110954
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110955
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110956
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110957
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110958
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 349514
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110959
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110960
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0