CMS Formulary

Displaying 100331-100340 of 1611142 results.
ID: 100331
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100332
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100333
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100334
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100335
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 825335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100336
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100337
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100338
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100339
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040025
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 35
Qty Limit Days: 28
ID: 100340
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0