CMS Formulary

Displaying 103991-104000 of 1611142 results.
ID: 103991
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103992
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 204509
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103993
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103994
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103995
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103996
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664981
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103997
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103998
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103999
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104000
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0