CMS Formulary

Displaying 106161-106170 of 1611142 results.
ID: 106161
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106162
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106163
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106164
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091170
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106165
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 106166
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091210
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106167
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106168
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 106169
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106170
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0