CMS Formulary

Displaying 107041-107050 of 1611142 results.
ID: 107041
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107042
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107043
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107044
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 858778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 107045
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107046
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107047
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107048
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107049
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107050
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099686
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28