CMS Formulary

Displaying 105821-105830 of 1611142 results.
ID: 105821
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105822
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105823
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105824
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105825
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105826
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105827
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105828
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105829
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105830
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0