CMS Formulary

Displaying 106041-106050 of 1611142 results.
ID: 106041
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106042
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 106043
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106044
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106045
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106046
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 106047
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106048
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106049
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106050
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0