CMS Formulary

Displaying 106611-106620 of 1611142 results.
ID: 106611
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 477451
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 106612
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106613
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106614
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106615
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 106616
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106617
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106618
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106619
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106620
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0