CMS Formulary

Displaying 105221-105230 of 1611142 results.
ID: 105221
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105222
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105223
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 757707
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105224
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 403957
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105225
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105226
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105227
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 105228
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105229
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105230
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0