CMS Formulary

Displaying 106291-106300 of 1611142 results.
ID: 106291
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 896766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106292
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106293
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313888
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106294
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106295
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106296
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106297
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106298
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25
ID: 106299
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 213262
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106300
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0