CMS Formulary

Displaying 104271-104280 of 1611142 results.
ID: 104271
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104272
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104273
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104274
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104275
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104276
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104277
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104278
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104279
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104280
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048025
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0