CMS Formulary

Displaying 103811-103820 of 1611142 results.
ID: 103811
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103812
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103813
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103814
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103815
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103816
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006120
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103817
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2260709
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103818
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103819
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 309045
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103820
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0