CMS Formulary

Displaying 103621-103630 of 1611142 results.
ID: 103621
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 103622
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 103623
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 103624
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 103625
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649961
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 103626
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103627
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103628
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103629
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103630
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30