CMS Formulary

Displaying 110491-110500 of 1611142 results.
ID: 110491
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110492
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110493
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110494
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110495
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110496
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110497
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110498
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110499
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 110500
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30