CMS Formulary

Displaying 109861-109870 of 1611142 results.
ID: 109861
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109862
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109863
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109864
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109865
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109866
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109867
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109868
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109869
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 863628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109870
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 314080
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0