CMS Formulary

Displaying 103891-103900 of 1611142 results.
ID: 103891
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103892
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103893
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103894
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103895
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103896
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103897
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103898
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103899
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103900
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0