CMS Formulary

Displaying 101931-101940 of 1611142 results.
ID: 101931
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101932
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 856706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101933
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101934
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101935
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 101936
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 101937
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101938
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101939
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 101940
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0