CMS Formulary

Displaying 109341-109350 of 1611142 results.
ID: 109341
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109342
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109343
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109344
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109345
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109346
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109347
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109348
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109349
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 109350
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30