CMS Formulary

Displaying 108931-108940 of 1611142 results.
ID: 108931
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108932
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108933
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108934
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 108935
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108936
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108937
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860151
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108938
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 108939
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 108940
Formulary ID: 00021042
Formulary Version: 14
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0