CMS Formulary

Displaying 100471-100480 of 1611142 results.
ID: 100471
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100472
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30
ID: 100473
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100474
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100475
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100476
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100477
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100478
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100479
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 100480
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0