CMS Formulary

Displaying 108821-108830 of 1611142 results.
ID: 108821
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108822
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 108823
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108824
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108825
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108826
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108827
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108828
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108829
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108830
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 309043
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0