CMS Formulary

Displaying 102491-102500 of 1611142 results.
ID: 102491
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 977942
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 102492
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102493
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102494
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102495
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102496
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102497
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102498
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102499
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102500
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30