CMS Formulary

Displaying 100391-100400 of 1611142 results.
ID: 100391
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100392
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100393
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100394
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100395
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100396
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100397
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100398
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442681
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100399
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442683
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100400
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0