CMS Formulary

Displaying 105781-105790 of 1611142 results.
ID: 105781
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 105782
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105783
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105784
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 105785
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 105786
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105787
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806187
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105788
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105789
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806191
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 105790
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806193
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30