CMS Formulary

Displaying 107691-107700 of 1611142 results.
ID: 107691
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107692
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107693
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107694
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107695
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107696
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107697
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107698
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107699
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107700
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0