CMS Formulary

Displaying 102991-103000 of 1611142 results.
ID: 102991
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102992
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102993
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 102994
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102995
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102996
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102997
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102998
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 102999
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103000
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0