CMS Formulary

Displaying 105731-105740 of 1611142 results.
ID: 105731
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105732
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105733
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105734
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105735
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105736
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105737
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105738
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105739
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105740
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30