CMS Formulary

Displaying 105041-105050 of 1611142 results.
ID: 105041
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105042
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105043
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105044
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105045
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105046
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105047
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105048
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105049
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 105050
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28