CMS Formulary

Displaying 109711-109720 of 1611142 results.
ID: 109711
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 795918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109712
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109713
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109714
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 996097
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109715
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 109716
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 109717
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 109718
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 109719
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109720
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0