CMS Formulary

Displaying 103081-103090 of 1611142 results.
ID: 103081
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103082
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103083
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103084
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103085
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103086
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 103087
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103088
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103089
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 103090
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28