CMS Formulary

Displaying 102221-102230 of 1611142 results.
ID: 102221
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102222
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102223
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102224
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102225
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102226
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 4
ID: 102227
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102228
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102229
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 102230
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30