CMS Formulary

Displaying 108891-108900 of 1611142 results.
ID: 108891
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 108892
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108893
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108894
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 108895
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860157
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108896
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860129
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108897
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860137
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108898
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108899
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108900
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0