CMS Formulary

Displaying 107451-107460 of 1611142 results.
ID: 107451
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309045
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107452
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107453
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107454
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107455
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107456
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107457
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107458
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107459
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107460
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30