CMS Formulary

Displaying 107731-107740 of 1611142 results.
ID: 107731
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107732
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 107733
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107734
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 107735
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 107736
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 107737
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 107738
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 107739
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 107740
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0