CMS Formulary

Displaying 107911-107920 of 1611142 results.
ID: 107911
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107912
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048025
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107913
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107914
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107915
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107916
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107917
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107918
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107919
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 107920
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0