CMS Formulary

Displaying 107891-107900 of 1611142 results.
ID: 107891
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107892
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107893
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 896184
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107894
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 896209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107895
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 896228
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107896
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107897
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107898
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107899
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107900
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30