CMS Formulary

Displaying 107211-107220 of 1611142 results.
ID: 107211
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 802652
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107212
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653225
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107213
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107214
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107215
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107216
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107217
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107218
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107219
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107220
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30