CMS Formulary

Displaying 109281-109290 of 1611142 results.
ID: 109281
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109282
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109283
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109284
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109285
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109286
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109287
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109288
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 359697
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109289
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109290
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0