CMS Formulary

Displaying 100871-100880 of 1611142 results.
ID: 100871
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100872
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100873
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100874
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100875
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 100876
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 312504
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100877
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100878
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100879
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100880
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0