CMS Formulary

Displaying 102941-102950 of 1611142 results.
ID: 102941
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102942
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102943
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102944
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797883
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 102945
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 102946
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102947
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 141859
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 4
ID: 102948
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 102949
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102950
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244634
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0