CMS Formulary

Displaying 103111-103120 of 1611142 results.
ID: 103111
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103112
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103113
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103114
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103115
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103116
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103117
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1146690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103118
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 577776
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103119
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103120
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0