CMS Formulary

Displaying 103471-103480 of 1611142 results.
ID: 103471
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103472
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103473
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103474
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103475
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1668238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103476
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103477
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103478
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103479
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396905
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103480
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1492746
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0