CMS Formulary

Displaying 108061-108070 of 1611142 results.
ID: 108061
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108062
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108063
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108064
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108065
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108066
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108067
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108068
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108069
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108070
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30