CMS Formulary

Displaying 105511-105520 of 1611142 results.
ID: 105511
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105512
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105513
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 105514
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 105515
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 105516
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105517
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105518
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105519
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105520
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30