CMS Formulary

Displaying 100691-100700 of 1611142 results.
ID: 100691
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100692
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257015
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 100693
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100694
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100695
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044732
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100696
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100697
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100698
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100699
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100700
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0