CMS Formulary

Displaying 108201-108210 of 1611142 results.
ID: 108201
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108202
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 108203
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108204
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108205
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108206
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108207
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108208
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108209
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108210
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0