CMS Formulary

Displaying 102031-102040 of 1611142 results.
ID: 102031
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102032
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 102033
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110510
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102034
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110513
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102035
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110516
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102036
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 102037
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 102038
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 211343
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102039
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 102040
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30