CMS Formulary

Displaying 107531-107540 of 1611142 results.
ID: 107531
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107532
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107533
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107534
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107535
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107536
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107537
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107538
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107539
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107540
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30