CMS Formulary

Displaying 108341-108350 of 1611142 results.
ID: 108341
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 108342
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 108343
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108344
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108345
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108346
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108347
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108348
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108349
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108350
Formulary ID: 00021040
Formulary Version: 14
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0