CMS Formulary

Displaying 105361-105370 of 1611142 results.
ID: 105361
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105362
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105363
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 103401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105364
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105365
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105366
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311033
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 105367
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311027
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 105368
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 105369
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 105370
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28