CMS Formulary

Displaying 107941-107950 of 1611142 results.
ID: 107941
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107942
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107943
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107944
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 107945
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 107946
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 107947
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107948
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257015
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 107949
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107950
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30