CMS Formulary

Displaying 110531-110540 of 1611142 results.
ID: 110531
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110532
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110533
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 110534
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110535
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 110536
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110537
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 110538
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110539
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110540
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0