CMS Formulary

Displaying 103591-103600 of 1611142 results.
ID: 103591
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 103592
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049504
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103593
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049545
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103594
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103595
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103596
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103597
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103598
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 103599
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 103600
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0