CMS Formulary

Displaying 101711-101720 of 1611142 results.
ID: 101711
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101712
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550940
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101713
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101714
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101715
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101716
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101717
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 101718
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101719
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101720
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0