CMS Formulary

Displaying 100921-100930 of 1611142 results.
ID: 100921
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100922
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100923
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100924
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 100925
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2393794
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 100926
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121764
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100927
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173841
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100928
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364477
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100929
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 100930
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28