CMS Formulary

Displaying 108791-108800 of 1611142 results.
ID: 108791
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108792
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108793
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108794
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 108795
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 108796
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108797
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108798
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108799
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108800
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0