CMS Formulary

Displaying 102331-102340 of 1611142 results.
ID: 102331
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102332
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102333
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102334
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2171002
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102335
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102336
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102337
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102338
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102339
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 859867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102340
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 992481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0