CMS Formulary

Displaying 105951-105960 of 1611142 results.
ID: 105951
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105952
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197426
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 105953
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 859315
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 105954
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 105955
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105956
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105957
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105958
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105959
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 105960
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0