CMS Formulary

Displaying 102441-102450 of 1611142 results.
ID: 102441
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102442
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102443
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 102444
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 102445
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102446
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102447
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102448
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102449
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102450
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30