CMS Formulary

Displaying 109571-109580 of 1611142 results.
ID: 109571
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 109572
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 109573
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 109574
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109575
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109576
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109577
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109578
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109579
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197426
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 109580
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 859315
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30