CMS Formulary

Displaying 106881-106890 of 1611142 results.
ID: 106881
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 106882
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 106883
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 106884
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 106885
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 106886
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 106887
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 106888
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 106889
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 106890
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30