CMS Formulary

Displaying 105311-105320 of 1611142 results.
ID: 105311
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105312
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105313
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105314
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105315
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 903857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105316
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105317
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856660
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105318
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856652
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105319
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105320
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0