CMS Formulary

Displaying 110191-110200 of 1611142 results.
ID: 110191
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122648
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110192
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122642
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110193
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110194
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110195
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110196
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110197
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110198
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110199
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110200
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0