CMS Formulary

Displaying 110371-110380 of 1611142 results.
ID: 110371
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110372
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110373
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1146690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110374
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 577776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110375
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110376
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110377
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110378
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 851750
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110379
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 110380
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0