CMS Formulary

Displaying 108141-108150 of 1611142 results.
ID: 108141
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108142
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108143
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108144
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108145
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108146
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108147
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 108148
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108149
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 108150
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 866905
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0