CMS Formulary

Displaying 105681-105690 of 1611142 results.
ID: 105681
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 105682
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 105683
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 105684
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 105685
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105686
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105687
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 105688
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 105689
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 105690
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30