CMS Formulary

Displaying 107481-107490 of 1611142 results.
ID: 107481
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 107482
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107483
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107484
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107485
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 107486
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 107487
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107488
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 107489
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107490
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0