CMS Formulary

Displaying 105201-105210 of 1611142 results.
ID: 105201
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105202
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105203
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105204
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855318
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105205
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105206
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105207
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105208
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105209
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105210
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0