CMS Formulary

Displaying 104591-104600 of 1611142 results.
ID: 104591
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 104592
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 104593
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104594
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104595
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 104596
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104597
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104598
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104599
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 104600
Formulary ID: 00021039
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0