CMS Formulary

Displaying 106311-106320 of 1611142 results.
ID: 106311
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106312
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106313
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106314
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106315
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106316
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106317
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106318
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106319
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106320
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30