CMS Formulary

Displaying 109191-109200 of 1611142 results.
ID: 109191
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109192
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856792
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109193
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198297
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109194
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109195
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109196
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109197
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109198
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 109199
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 109200
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0