CMS Formulary

Displaying 110261-110270 of 1611142 results.
ID: 110261
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110262
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1943345
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110263
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110264
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 110265
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110266
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110267
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110268
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 110269
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110270
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056748
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25