CMS Formulary

Displaying 106061-106070 of 1611142 results.
ID: 106061
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 854238
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 106062
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 106063
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 854248
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 106064
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 854245
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 106065
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 106066
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 406503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106067
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 858262
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106068
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106069
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106070
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0