CMS Formulary

Displaying 102281-102290 of 1611142 results.
ID: 102281
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102282
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102283
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102284
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 102285
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102286
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 28
ID: 102287
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 102288
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102289
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102290
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30