CMS Formulary

Displaying 102701-102710 of 1611142 results.
ID: 102701
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102702
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102703
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102704
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102705
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102706
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 102707
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 102708
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102709
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102710
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0