CMS Formulary

Displaying 102301-102310 of 1611142 results.
ID: 102301
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102302
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 102303
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102304
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102305
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102306
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 102307
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102308
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102309
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102310
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30