CMS Formulary

Displaying 109991-110000 of 1611142 results.
ID: 109991
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 109992
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 109993
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109994
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109995
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109996
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109997
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109998
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109999
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110000
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0