CMS Formulary

Displaying 102531-102540 of 1611142 results.
ID: 102531
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102532
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091170
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102533
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 102534
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091210
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102535
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102536
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 102537
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102538
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102539
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102540
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0