CMS Formulary

Displaying 109231-109240 of 1611142 results.
ID: 109231
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109232
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109233
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109234
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109235
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109236
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109237
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109238
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109239
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 109240
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0