CMS Formulary

Displaying 107011-107020 of 1611142 results.
ID: 107011
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115012
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 107012
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115013
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 107013
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107014
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107015
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107016
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107017
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107018
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 107019
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107020
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0