CMS Formulary

Displaying 109521-109530 of 1611142 results.
ID: 109521
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 857564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109522
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109523
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109524
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 109525
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109526
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109527
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109528
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109529
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 109530
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0