CMS Formulary

Displaying 105581-105590 of 1611142 results.
ID: 105581
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105582
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105583
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 105584
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 105585
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 105586
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105587
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 876524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105588
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 876514
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105589
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 876529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105590
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 876519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0