CMS Formulary

Displaying 110161-110170 of 1611142 results.
ID: 110161
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110162
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110163
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110164
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110165
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110166
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 252479
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110167
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110168
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110169
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110170
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0