CMS Formulary

Displaying 109891-109900 of 1611142 results.
ID: 109891
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 109892
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 109893
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109894
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109895
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109896
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109897
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 109898
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 109899
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 109900
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30