CMS Formulary

Displaying 100351-100360 of 1611142 results.
ID: 100351
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100352
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100353
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100354
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100355
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 483427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100356
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 483425
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100357
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100358
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100359
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100360
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0