CMS Formulary

Displaying 107961-107970 of 1611142 results.
ID: 107961
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107962
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107963
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107964
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30
ID: 107965
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30
ID: 107966
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107967
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107968
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107969
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107970
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0