CMS Formulary

Displaying 107871-107880 of 1611142 results.
ID: 107871
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107872
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729029
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107873
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729033
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107874
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729047
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107875
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729076
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107876
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 107877
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107878
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107879
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 727714
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107880
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0