CMS Formulary

Displaying 110061-110070 of 1611142 results.
ID: 110061
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110062
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 110063
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 110064
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 110065
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110066
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110067
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110068
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 110069
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110070
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0