CMS Formulary

Displaying 108071-108080 of 1611142 results.
ID: 108071
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108072
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108073
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108074
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108075
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108076
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108077
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108078
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108079
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 108080
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0