CMS Formulary

Displaying 105761-105770 of 1611142 results.
ID: 105761
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 105762
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 105763
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105764
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105765
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105766
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105767
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105768
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105769
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105770
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0