CMS Formulary

Displaying 107121-107130 of 1611142 results.
ID: 107121
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107122
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107123
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 107124
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2120195
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 107125
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 107126
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 727537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107127
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648162
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107128
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648160
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107129
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048718
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107130
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048722
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30