CMS Formulary

Displaying 110961-110970 of 1611142 results.
ID: 110961
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110962
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 308459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110963
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 141963
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110964
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198317
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 110965
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198318
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110966
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 110967
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 110968
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110969
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311727
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110970
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0