CMS Formulary

Displaying 106861-106870 of 1611142 results.
ID: 106861
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 106862
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 106863
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 106864
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 7
ID: 106865
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106866
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106867
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106868
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106869
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106870
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0