CMS Formulary

Displaying 101861-101870 of 1611142 results.
ID: 101861
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101862
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101863
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101864
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101865
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101866
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101867
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101868
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101869
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 101870
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30