CMS Formulary

Displaying 110481-110490 of 1611142 results.
ID: 110481
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110482
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110483
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110484
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110485
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 110486
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 110487
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110488
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 7
ID: 110489
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861353
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110490
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0