CMS Formulary

Displaying 102231-102240 of 1611142 results.
ID: 102231
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 102232
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102233
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102234
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102235
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102236
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102237
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197653
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102238
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102239
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102240
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30