CMS Formulary

Displaying 109631-109640 of 1611142 results.
ID: 109631
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109632
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109633
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 828755
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109634
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 828539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109635
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109636
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 645884
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109637
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 757968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109638
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 109639
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197411
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109640
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310600
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0