CMS Formulary

Displaying 101051-101060 of 1611142 results.
ID: 101051
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101052
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101053
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661799
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 101054
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946589
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 30
ID: 101055
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101056
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101057
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101058
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101059
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045959
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101060
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045961
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30