CMS Formulary

Displaying 105521-105530 of 1611142 results.
ID: 105521
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105522
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105523
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 105524
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 105525
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105526
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105527
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105528
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105529
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105530
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0