CMS Formulary

Displaying 109221-109230 of 1611142 results.
ID: 109221
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 876519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109222
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109223
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966220
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109224
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109225
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109226
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109227
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 892246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109228
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966248
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109229
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109230
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 966225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0