CMS Formulary

Displaying 108941-108950 of 1611142 results.
ID: 108941
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108942
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108943
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108944
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108945
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108946
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108947
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 903857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108948
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108949
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856660
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108950
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856652
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0