CMS Formulary

Displaying 108921-108930 of 1611142 results.
ID: 108921
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108922
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108923
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108924
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108925
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108926
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108927
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108928
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108929
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 197737
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108930
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0