CMS Formulary

Displaying 100031-100040 of 1611142 results.
ID: 100031
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 100032
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 100033
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 100034
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100035
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100036
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100037
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100038
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100039
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100040
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0