CMS Formulary

Displaying 98621-98630 of 1611142 results.
ID: 98621
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98622
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 98623
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 98624
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 98625
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 250344
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98626
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 98627
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 98628
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98629
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 197502
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98630
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0