CMS Formulary

Displaying 105161-105170 of 1611142 results.
ID: 105161
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105162
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 105163
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 105164
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105165
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105166
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105167
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105168
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105169
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105170
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0