CMS Formulary

Displaying 107091-107100 of 1611142 results.
ID: 107091
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107092
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107093
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 107094
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 994008
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107095
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 900156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107096
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 848582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107097
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 824959
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107098
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107099
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107100
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0