CMS Formulary

Displaying 101761-101770 of 1611142 results.
ID: 101761
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 101762
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 101763
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101764
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197392
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101765
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 597852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101766
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 597850
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101767
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101768
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101769
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101770
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 866049
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30