CMS Formulary

Displaying 102871-102880 of 1611142 results.
ID: 102871
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102872
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102873
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102874
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1423080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102875
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102876
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102877
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102878
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102879
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102880
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0