CMS Formulary

Displaying 102171-102180 of 1611142 results.
ID: 102171
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102172
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102173
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102174
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102175
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102176
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102177
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102178
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102179
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102180
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0