CMS Formulary

Displaying 101601-101610 of 1611142 results.
ID: 101601
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 309958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101602
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 309960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101603
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 101604
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101605
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101606
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 101607
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 101608
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101609
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 309047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101610
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0