CMS Formulary

Displaying 107861-107870 of 1611142 results.
ID: 107861
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107862
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107863
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 352066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107864
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107865
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 107866
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107867
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 107868
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107869
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107870
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30