CMS Formulary

Displaying 110581-110590 of 1611142 results.
ID: 110581
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 110582
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197654
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 110583
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110584
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 238153
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 110585
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110586
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110587
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 835956
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110588
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110589
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110590
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0