CMS Formulary

Displaying 110781-110790 of 1611142 results.
ID: 110781
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110782
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110783
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110784
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110785
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110786
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110787
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110788
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 110789
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 110790
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30