CMS Formulary

Displaying 103381-103390 of 1611142 results.
ID: 103381
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103382
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103383
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103384
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103385
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103386
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 103387
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103388
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103389
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103390
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30