CMS Formulary

Displaying 105561-105570 of 1611142 results.
ID: 105561
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856792
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105562
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105563
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105564
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105565
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105566
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105567
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 105568
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105569
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105570
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0