CMS Formulary

Displaying 110241-110250 of 1611142 results.
ID: 110241
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110242
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 110243
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110244
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110245
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110246
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110247
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110248
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110249
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110250
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0