CMS Formulary

Displaying 108301-108310 of 1611142 results.
ID: 108301
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108302
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 108303
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 108304
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108305
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 1927682
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14
ID: 108306
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108307
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108308
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108309
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108310
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0