CMS Formulary

Displaying 107201-107210 of 1611142 results.
ID: 107201
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 107202
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107203
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107204
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107205
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107206
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107207
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107208
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107209
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107210
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 809159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0