CMS Formulary

Displaying 109201-109210 of 1611142 results.
ID: 109201
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109202
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109203
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109204
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197318
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109205
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109206
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109207
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109208
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109209
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109210
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0