CMS Formulary

Displaying 106121-106130 of 1611142 results.
ID: 106121
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 106122
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 977939
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 106123
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 977942
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 106124
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106125
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106126
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106127
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106128
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106129
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106130
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0