CMS Formulary

Displaying 103071-103080 of 1611142 results.
ID: 103071
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103072
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103073
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103074
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103075
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103076
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103077
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103078
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103079
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103080
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0