CMS Formulary

Displaying 105541-105550 of 1611142 results.
ID: 105541
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105542
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 105543
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 105544
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105545
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105546
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105547
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105548
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 105549
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105550
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0