CMS Formulary

Displaying 105851-105860 of 1611142 results.
ID: 105851
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 105852
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313941
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 105853
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105854
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105855
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105856
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105857
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105858
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 4
ID: 105859
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105860
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0