CMS Formulary

Displaying 107101-107110 of 1611142 results.
ID: 107101
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107102
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107103
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107104
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107105
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107106
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107107
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1668238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107108
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107109
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107110
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0