CMS Formulary

Displaying 105031-105040 of 1611142 results.
ID: 105031
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2469340
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105032
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 105033
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 105034
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 105035
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105036
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 105037
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105038
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105039
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105040
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28