CMS Formulary

Displaying 105841-105850 of 1611142 results.
ID: 105841
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 753483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105842
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 750267
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105843
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095229
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105844
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105845
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105846
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105847
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105848
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105849
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105850
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0