CMS Formulary

Displaying 109781-109790 of 1611142 results.
ID: 109781
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109782
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 900164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109783
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 850091
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109784
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 850087
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109785
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109786
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109787
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109788
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109789
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109790
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091155
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30