CMS Formulary

Displaying 104601-104610 of 1611142 results.
ID: 104601
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104602
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 198032
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104603
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104604
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104605
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197854
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104606
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104607
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104608
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104609
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104610
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0