CMS Formulary

Displaying 104541-104550 of 1611142 results.
ID: 104541
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104542
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104543
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104544
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104545
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104546
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 245723
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104547
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104548
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104549
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104550
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0