CMS Formulary

Displaying 106101-106110 of 1611142 results.
ID: 106101
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 106102
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 106103
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 106104
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 106105
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 106106
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 106107
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106108
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 106109
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006122
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106110
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30