CMS Formulary

Displaying 108901-108910 of 1611142 results.
ID: 108901
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108902
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108903
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108904
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108905
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108906
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108907
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108908
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108909
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108910
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0