CMS Formulary

Displaying 109451-109460 of 1611142 results.
ID: 109451
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109452
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109453
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109454
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109455
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109456
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109457
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109458
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109459
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109460
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0