CMS Formulary

Displaying 109171-109180 of 1611142 results.
ID: 109171
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 801031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109172
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109173
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 109174
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 109175
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109176
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109177
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109178
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109179
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 109180
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0