CMS Formulary

Displaying 107981-107990 of 1611142 results.
ID: 107981
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107982
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107983
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107984
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107985
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 107986
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107987
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107988
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107989
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 107990
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0