CMS Formulary

Displaying 109061-109070 of 1611142 results.
ID: 109061
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109062
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109063
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109064
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109065
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109066
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109067
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109068
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109069
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109070
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0