CMS Formulary

Displaying 100701-100710 of 1611142 results.
ID: 100701
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100702
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100703
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100704
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100705
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100706
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100707
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100708
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30
ID: 100709
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30
ID: 100710
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0