CMS Formulary

Displaying 109161-109170 of 1611142 results.
ID: 109161
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109162
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109163
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 800420
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109164
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109165
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090639
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109166
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 800438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109167
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 800444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109168
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 801012
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109169
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 801000
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109170
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 801021
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0