CMS Formulary

Displaying 102881-102890 of 1611142 results.
ID: 102881
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102882
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102883
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102884
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102885
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102886
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 102887
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102888
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 102889
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102890
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0