CMS Formulary

Displaying 101901-101910 of 1611142 results.
ID: 101901
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101902
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090639
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101903
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 800438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101904
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 800444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101905
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 801012
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101906
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 801000
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101907
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 801021
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101908
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 801031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101909
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101910
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30