CMS Formulary

Displaying 107681-107690 of 1611142 results.
ID: 107681
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 977874
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107682
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 977894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107683
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 977902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107684
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107685
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107686
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107687
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107688
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107689
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 107690
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30