CMS Formulary

Displaying 107821-107830 of 1611142 results.
ID: 107821
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107822
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107823
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107824
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107825
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107826
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107827
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107828
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107829
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107830
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0