CMS Formulary

Displaying 107761-107770 of 1611142 results.
ID: 107761
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107762
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107763
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107764
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107765
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107766
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107767
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107768
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107769
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107770
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0