CMS Formulary

Displaying 102251-102260 of 1611142 results.
ID: 102251
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102252
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102253
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102254
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102255
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102256
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 102257
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 102258
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 102259
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 102260
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0