CMS Formulary

Displaying 103231-103240 of 1611142 results.
ID: 103231
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 103232
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 7
ID: 103233
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 861353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103234
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103235
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103236
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103237
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103238
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103239
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103240
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30