CMS Formulary

Displaying 107001-107010 of 1611142 results.
ID: 107001
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107002
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107003
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107004
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107005
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 107006
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 107007
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107008
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107009
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107010
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0