CMS Formulary

Displaying 107621-107630 of 1611142 results.
ID: 107621
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107622
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107623
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107624
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 204509
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107625
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107626
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107627
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107628
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664981
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107629
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107630
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0