CMS Formulary

Displaying 105611-105620 of 1611142 results.
ID: 105611
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 105612
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 105613
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 105614
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 105615
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105616
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105617
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105618
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105619
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105620
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0