CMS Formulary

Displaying 102001-102010 of 1611142 results.
ID: 102001
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102002
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102003
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102004
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 102005
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102006
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 102007
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102008
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 102009
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 102010
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30