CMS Formulary

Displaying 109901-109910 of 1611142 results.
ID: 109901
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109902
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109903
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649429
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109904
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109905
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109906
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 406524
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109907
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 434018
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109908
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 799048
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109909
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 109910
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 897666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0