CMS Formulary

Displaying 108591-108600 of 1611142 results.
ID: 108591
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 108592
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108593
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108594
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108595
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108596
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108597
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108598
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108599
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108600
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30