CMS Formulary

Displaying 100721-100730 of 1611142 results.
ID: 100721
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 835577
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100722
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100723
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100724
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100725
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100726
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100727
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100728
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100729
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100730
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0