CMS Formulary

Displaying 100301-100310 of 1611142 results.
ID: 100301
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 476350
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100302
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 476351
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100303
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100304
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 100305
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100306
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100307
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100308
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299911
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100309
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100310
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0