CMS Formulary

Displaying 100431-100440 of 1611142 results.
ID: 100431
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 977909
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100432
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 977915
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100433
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100434
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100435
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100436
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 100437
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 100438
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100439
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100440
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0