CMS Formulary

Displaying 98241-98250 of 1611142 results.
ID: 98241
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98242
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98243
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98244
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98245
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98246
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98247
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 794639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 98248
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 98249
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98250
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0