CMS Formulary

Displaying 101771-101780 of 1611142 results.
ID: 101771
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896019
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101772
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896027
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 101773
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896023
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101774
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101775
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 180
ID: 101776
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101777
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101778
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101779
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 101780
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30