CMS Formulary

Displaying 108911-108920 of 1611142 results.
ID: 108911
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 108912
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108913
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108914
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108915
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 108916
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108917
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108918
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108919
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108920
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30