CMS Formulary

Displaying 105741-105750 of 1611142 results.
ID: 105741
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105742
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105743
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105744
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105745
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105746
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105747
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 105748
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105749
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105750
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30