CMS Formulary

Displaying 103441-103450 of 1611142 results.
ID: 103441
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103442
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103443
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103444
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 994005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103445
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103446
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103447
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103448
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103449
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103450
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0