CMS Formulary

Displaying 102811-102820 of 1611142 results.
ID: 102811
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102812
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102813
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102814
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 102815
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102816
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102817
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102818
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102819
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102820
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0