CMS Formulary

Displaying 105901-105910 of 1611142 results.
ID: 105901
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105902
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 105903
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105904
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105905
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105906
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105907
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105908
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105909
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105910
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0