CMS Formulary

Displaying 104191-104200 of 1611142 results.
ID: 104191
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104192
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104193
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104194
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104195
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104196
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104197
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104198
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104199
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104200
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30