CMS Formulary

Displaying 108261-108270 of 1611142 results.
ID: 108261
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108262
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108263
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380617
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108264
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108265
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108266
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 108267
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108268
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108269
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108270
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0