CMS Formulary

Displaying 104921-104930 of 1611142 results.
ID: 104921
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104922
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876406
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104923
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2375329
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104924
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104925
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003757
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104926
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003767
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104927
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104928
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104929
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104930
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0