CMS Formulary

Displaying 104661-104670 of 1611142 results.
ID: 104661
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722676
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104662
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104663
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941470
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104664
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941476
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104665
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104666
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104667
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104668
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104669
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104670
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25