CMS Formulary

Displaying 103531-103540 of 1611142 results.
ID: 103531
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103532
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 103533
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 103534
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 103535
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103536
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103537
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 999986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103538
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103539
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103540
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0