CMS Formulary

Displaying 109841-109850 of 1611142 results.
ID: 109841
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109842
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 109843
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 109844
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 109845
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 109846
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109847
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109848
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 109849
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 109850
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30