CMS Formulary

Displaying 108111-108120 of 1611142 results.
ID: 108111
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108112
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108113
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108114
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108115
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108116
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108117
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108118
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108119
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108120
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30