CMS Formulary

Displaying 105451-105460 of 1611142 results.
ID: 105451
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105452
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098608
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105453
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 105454
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 105455
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 105456
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 105457
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198057
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 105458
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 105459
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198059
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 105460
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0