CMS Formulary

Displaying 106981-106990 of 1611142 results.
ID: 106981
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106982
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 993943
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 106983
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 994239
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 106984
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106985
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012904
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106986
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 106987
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 106988
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 106989
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 106990
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0