CMS Formulary

Displaying 106081-106090 of 1611142 results.
ID: 106081
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106082
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 106083
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106084
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 795918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106085
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106086
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106087
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 996097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106088
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106089
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106090
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30