CMS Formulary

Displaying 103981-103990 of 1611142 results.
ID: 103981
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103982
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 103983
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103984
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103985
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103986
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103987
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103988
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103989
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103990
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0