CMS Formulary

Displaying 100671-100680 of 1611142 results.
ID: 100671
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 100672
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100673
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100674
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100675
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100676
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100677
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100678
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 100679
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100680
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0