CMS Formulary

Displaying 103601-103610 of 1611142 results.
ID: 103601
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103602
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103603
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103604
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103605
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544396
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103606
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103607
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103608
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 103609
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 103610
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30