CMS Formulary

Displaying 98781-98790 of 1611142 results.
ID: 98781
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 98782
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 98783
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 98784
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 98785
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98786
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98787
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 849395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98788
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98789
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 98790
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0