CMS Formulary

Displaying 100271-100280 of 1611142 results.
ID: 100271
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100272
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100273
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100274
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100275
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100276
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100277
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100278
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100279
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100280
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0