CMS Formulary

Displaying 105331-105340 of 1611142 results.
ID: 105331
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105332
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105333
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105334
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105335
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 105336
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105337
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105338
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105339
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105340
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0