CMS Formulary

Displaying 103121-103130 of 1611142 results.
ID: 103121
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103122
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 851750
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103123
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103124
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103125
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103126
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103127
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103128
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2104192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103129
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994764
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103130
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0